The Current State of Nursing Education, Part I – BSNs, Certification and Professional Development

September 16, 2011 - Completing a nursing program to obtain licensure represents the beginning, not the end, of a nurses’ educational preparation. With a rapidly changing health care environment, more nurses are seeking specialty certification and baccalaureate degrees.

Dawn Bazarko, DNP, MPH, RN, said nurses will need additional education to lead the changes happening in health care.

“One of the keys to solving our health care dilemma in the United States is to better prepare a nursing workforce that has competencies necessary to lead transformative change, and nurses are positioned to do that with the patient in mind,” said Dawn Bazarko, DNP, MPH, RN, senior vice president of UnitedHealth Group’s Center for Nursing Advancement in Minneapolis.

Rose Sherman, EdD, RN, NEA-BC, CNL, FAAN, said additional education will open doors and lead to personal growth.

Rose Sherman, EdD, RN, NEA-BC, CNL, FAAN, director of the Nursing Leadership Institute at Florida Atlantic University in Boca Raton, also cites the complexity of the health care environment as a factor in the need for more education.

“It’s hard to function in this complex, changing environment without a really strong, knowledge-based skill set,” Sherman said. “Education can help master this environment.”

“Lifelong learning is an expectation for nurses from the bedside to the board room,” said June Marshall, DNP, RN, NEA-BC, director of advancing professional nursing practice at Texas Health Presbyterian Hospital Dallas, adding, “Nurses today have many opportunities for defining their career paths and choosing a course of action that will help them accomplish their professional and personal goals.”

In addition, the Institute of Medicine’s Future of Nursing Leading Change, Advancing Health report, issued last fall, encourages lifelong learning and bachelor’s preparation for 80 percent of nurses.

Sherman has found with so many hospitals preferring to hire BSN-prepared nurses, new graduates are more quickly returning to school to become competitive.

Certification and professional development

Beaumont Health System in Royal Oak, Mich., values specialty certification and offers review courses and reimbursement for the exam, said Lorna Gallogly, MSN, APN B-C, a clinical nurse specialist at Beaumont. She said, “It shows expertise in an area.”

The desire for hospitals to earn and maintain Magnet designation is driving more nurses to obtain specialty certification and bachelor’s degrees, Sherman said.

“If you want to move up in the organization, the need to continue your education and get certified in your specialty area is more compelling than it was five years ago,” Sherman said.

Karen Drenkard, Ph.D., RN, NEA-BC, FAAN, executive director of the American Nurses Credentialing Center in Silver Spring, Md., confirms an increase in interest in specialty certification and Magnet designation. In early September 2011, 389 hospitals had obtained Magnet status, and 100 were in the pipeline.

“Hospitals are looking to Magnet standards for improving quality and safety, and having nurses who have been certified demonstrates the competence and knowledge they have in a specialty area,” Drenkard said. “Certification is something nurses want as proof of their expertise.”

Deborah Echtenkamp, MSN, RN, CPON, president of the Association of Pediatric Hematology/Oncology Nurses and a clinical nurse specialist in Dallas, encourages certification so the public knows those nurses are competent. The organization has issued a position paper emphasizing lifelong learning and certification.

“With health care changing, it’s important that nurses take the responsibility to continue to stay abreast of what is happening in their field,” Echtenkamp said.

Professional development

UnitedHealth Group takes additional education of its 7,000-nurse workforce seriously, establishing the Center for Nursing Advancement, creating career paths for RNs. Forty of the company’s nurses recently completed a pilot program, providing one-on-one mentoring and structured education about business, leadership in health care, nursing professionalism and other topics. The program was so successful--with 100 percent of nurses starting the program also finishing it--the company will offer it to a second cohort in October.

UnitedHealth Group also offers an executive leaders program, sponsored by the University of St. Thomas in Minneapolis, to develop broader leadership capacity and an executive mindset, so nurses can move up, said Bazarko, who taught executive communication as part of the program. Courses also covered change management, ethics and finance.

Baccalaureate degrees

Jan Jones-Schenk, RN, MNA, NE-BC, said a BSN will take nurses to the next level.

The Future of Nursing report recommends increasing the number of baccalaureate-prepared nurses from approximately 50 to 80 percent by 2020.

“In the ADN prelicensure programs, the focus is on developing clinical skills, and the BSN takes it to another level,” said Jan Jones-Schenk, RN, MNA, NE-BC, director of nursing programs at Western Governors University in Salt Lake City, adding that more schooling is needed to help nurses adjust to the rapid transformations in clinical care, as management of chronic illness moves to the community setting.

“There will be a sea-change shift in what skills people need, and that will drive nursing education,” Jones-Schenk said.

Bridget Nettleton, Ph.D., RN, said she considers a BSN a necessity, that nurses cannot stop at an associate degree or a diploma.

Several schools, including Western Governors and Empire State College in Saratoga Springs, have begun offering online RN-to-BSN programs to help busy nurses obtain their undergraduate degree.

“Adult learners who are self-motivated like the online, because it gives great flexibility,” said Bridget Nettleton, Ph.D, RN, dean of the nursing program at the State University of New York Empire State College, but she said demand still exists for face-to-face classes.

“An associate degree or diploma in nursing is an appropriate entry point, but you cannot stop there,” Nettleton said. “The bachelor’s is the next logical step for someone who wants to increase their potential to move into other career opportunities.”